Can I take steroids for my chronic hives?

Question

Hello doctor,

I am a 78 years old male. I have urticaria (hives) for a long time. I have been to local dermatologists many a time in the past few years. I have been taking one tablet of Allegra 180 daily for the past year. I have used and still using many creams, such as Evion, Flucort, vitamin E ointment, and many others intermittently over the past many years.

I am not seeking a cure for my problem because I know it cannot be cured entirely, but it has to be managed. In the last few weeks, I have developed a peculiar problem. When I am awake, I avoid scratching the itching skin. When I go to sleep at night, I wear knee-length socks, a long-sleeved shirt, and cotton gloves.

However, while asleep, I scratch despite wearing those coverings because I push the cloth coverings aside without realizing it. When the pain from scratching reaches a level to wake me up, I will start applying moisturizer and rearrange the coverings. After a few minutes, I go back to sleep. Some nights, I will not get up again in the night, and sometimes I will get up the second time and go through the whole rigmarole.

Because of COVID-19, my sons have locked me down in my room without allowing me to go out of the house. To while away time, I am surfing the internet for a few hours every day. In one of the sites, I read that a limited time-bound usage of steroid ‘Prednisone’ may alleviate the itch. I then remembered a health incident that happened to me more than eight years back. I developed a continuous dry cough for days. I then consulted ENT specialist.

She prescribed many a test, including a chest CT scan. She then prescribed Prednisone. It was a five-day regimen. For the first two days, I was prescribed a certain dosage of tablets. For the next two days, my dosage per day was halved. On the fifth day, I took only one pill. Believe it or not, my cough vanished.

I remember that my elders used to call that cough as a dog’s cough. My query is whether Prednisone or any other similar steroid will alleviate the symptoms of my urticaria. If it can, will you please prescribe me the regimen of such medication? How many days do I need to take the tablets? Should I take 5 mg, 10 mg, or any other? If you cannot ethically prescribe steroids without examining me, it is fine to disregard my request.

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Your concern is chronic urticaria. Usually, chronic urticaria is due to dry skin and dust allergy. There are many causes of urticaria, such as food, medication, dust, pets, or hair dye. In a few cases, it is idiopathic, meaning it has no cause.

Steroids only give you temporary relief with a lot of side effects at this time. I do not want to complicate. I will suggest a simple treatment plan.

Use a vacuum cleaner for dusting, if possible.
If your mattress is more than five years old, please change it.
Identify any possible triggers, such as animal proteins (chicken, mutton, fish, prawns, paneer), vegetables (carrot, beetroot, potato, sweet potato, groundnuts, drumsticks), colored foods (sauce, pickles), and wheat products (bread, biscuits). These are everyday food items that are culprits for many patients.
Try to avoid these food items for ten days, and then after, start having one after another, and try to identify the possible trigger. The list is vast and highly individualized.

I hope this helps you.

Take care.